“We just got back from Mexico!” I announced.
“How was it?” the third-string nutritionist asked.
“Great,” I said. “Everyone was really awesome about staying on the program. Bea worked really hard and did a great job.”
“It’s okay. It can be really hard to eat right on vacation,” she said, her voice dripping with understanding. My blood pressure started to rise. Why was this woman not getting it?
“She did great on vacation. She actually should be commended for how she did. I really think it’s the jeans.”
“How did you do on vacation, David?” she asked.
Silently Bea walked out of the room.
She went into the waiting room and started putting on her shoes. I waited a few seconds for the nutritionist to stop talking to David, whose vacation food choices were really kind of beside the point. I expected she would follow Bea to the waiting room to talk to her privately, or at least call out to her and ask what was wrong. But she did nothing of the sort. So I went out there.
I sat next to Bea, who was looking down at the floor.
I overheard the nutritionist continue the appointment with David. “Did you try any Mexican food?” she asked. I could not believe that conversation was going on while Bea had stormed out and no one had even blinked.
“Are you okay?” I asked Bea.
“No,” she said.
“Are you mad?” I asked.
She nodded.
“I totally understand. Do you want to leave?” I asked.
“Yes,” she said.
“Let’s get out of here.”
I went back into the office to fetch David.
“We’re going to go,” I announced. “I’ll call the office about scheduling the next appointment.” And we left.
I expected to receive a call from the main nutrition doctor over the next few days. Surely, I thought, the third-string nutritionist had told her that a patient had been upset enough to storm out of the office. Obviously, she would be concerned and would call to see how Bea was doing. No such call came.
“What should I do?” I asked Jeff.
“You shouldn’t go back. That doctor is annoying,” he pronounced in his typically blunt way, which I found so amusing and also clarifying. “You understand how to do the program, so do it. I don’t think going to those stupid appointments is what’s going to help Bea lose weight.”
Indeed, it had been an ongoing challenge for me to drag the kids there: David got little out of it, and Bea had twice left feeling bad because of how an apparent (if illusory) weight gain had been handled. They were delighted by the prospect of not going to that office every Friday.
For me, it wasn’t such an easy decision. I liked the program, and I even liked the nutrition doctor. And we were losing weight. I worried it was foolhardy to try to continue without the structure and guidance of a nutritionist’s supervision. As with Weight Watchers, as with Alcoholics Anonymous, there was benefit in going to a meeting.
But Jeff’s argument was legitimate: this was something we needed to be able to do on our own. The goal was to take over the reins and maintain a healthful way of eating without the supervision of a professional. Maybe that time had come.
We didn’t go back.
CHAPTER 12
The goal of any behavioral change is to do something you can live with independently. With our formal ties to the nutrition doctor severed, I wanted to make sure we were eating in a way that was sustainable for the long term. I wanted to make the program our own. I felt suddenly empowered to make some adjustments.
One of my first executive resolutions was abolishing unlimited late-night fruit snacks. I didn’t like how the requests were escalating later and later into the night, how I felt compelled to drag myself out of bed to wash and slice a piece of fruit because Bea had languidly called out from her room for an apple—something that was now happening two, three, four times a night.
I’d wrestled with the fruit ban. Fruit and vegetable snacks had always been “free,” un-fraught, and it was nice to be able to be relaxed about one food group. But I decided some limits needed to be set; it seemed to me that the volume of our fruit intake could, in fact, set us back.
I was careful not to extend this limitation to other times of day. Between after-school snack and dinner, Bea regularly had three or more pieces of fruit, in addition to those she had at school, and I was fine with that rate of consumption. But I felt it was fair to “close the kitchen” at a certain point. I understood from talking to parents of normal-weight kids that they did it. So I figured I could, too.
Another area I felt needed work was Bea’s relationship to food at school. From cafeteria fare to birthday cupcakes to class pizza parties, every day was a minefield. It was easy for Bea to feel isolated as the girl who couldn’t eat what the other kids ate, but letting her partake without restriction seemed impossible.
There are millions of obese kids in the United States, but for whatever reason, we don’t know any of them personally. I wish now that Bea and I could have looked just beyond our circle of friends—to the playground, the neighborhood, the buses and subways of New York—and seen that we were not alone. But at the time, all I could notice was that Bea’s social group was comprised almost entirely of wiry children who ate whatever they wanted, or blithely left half their lunches uneaten due to lack of interest. There was no other kid Bea knew going through the same struggle.
I knew she had moments of feeling left out, because she told me so.
“I feel cut off from the other kids, because I feel like they don’t have to go on a special diet,” she told me. “They don’t have to do something special. Just because I have to makes me different.”
And while youth culture today wonderfully encourages kids to celebrate their differences, this particular issue is usually left off the acceptance agenda. I wanted desperately to minimize this feeling of being “cut off,” as Bea put it. So I began by examining the behemoth of all school food: cafeteria lunch.
Anyone who’s spent time in a school cafeteria knows the lunch line is not for the weight conscious. I get it—in the school setting, in addition to the expediency of not bothering to make things low-calorie, there’s actually an argument to be made that lunches should contain lots and lots of calories. The school population is mostly made up of non-obese kids who are growing, need to be attentive in class, and probably run around a lot. On top of that, some of them come from low-income families that can’t afford enough food. These kids need to get hefty amounts of calories for their lunch money.
Thus, far from having calorie maximums for school lunches, there are actually government-mandated calorie minimums. Which, you may be surprised to hear me say, is as I think it should be. The underweight, very active, or poor should not have to suffer smaller portions and fewer calories because Bea and others like her are overweight. When I buy a pair of pants, I know I’m going to have to get them shortened, because I’m petite, and pants are designed to accommodate the tallest potential customer. Once manufactured, pants can’t be lengthened, but they can pretty easily be hemmed. I’m not thrilled about it, but I accept it. School lunch was similar: it was fair that Bea should have to adapt her behavior to a situation that was not calibrated for her specific nutritional needs.
I did feel that the calorie minimums were excessive, however, even for many healthy-weight kids. During that year, the USDA required that school lunches for grades K–3 contain at least 633 calories, and grades 4–12 needed to get at least 785 calories. And that didn’t include the salad bar. It bears noting that subsequently, these minimums were reduced, and maximums were introduced for the first time, with New York adopting a minimum/maximum range of 550–650 calories. But I couldn’t see how those numbers could ever line up with Bea’s under-300-calorie lunch requirement.
Initial attempts to let Bea eat lunch like a normal kid had backfired just enough for me to be scared off school lunches for a while. When we first started the tr
affic light program, I had continued to allow Bea to partake in school lunch once a week, on “pizza Fridays.” I didn’t want her to feel alienated, and she had explained its appeal in such poetic terms that I felt it was important to let her keep enjoying it.
“Do you still want to have pizza at school on Fridays?” I’d asked her.
“Yes!” she’d responded. “The cheese kind of melts in your mouth and the tomato sauce kind of blends in with everything.” When a food is described so adorably, how could I not try to oblige?
But fast-forward a couple of weeks to an early appointment with the nutrition doctor, when Bea had asked a question that alarmed me.
“So if I have pizza at school,” she had asked the doctor, “can I also get something else? Like a cold corn salad?”
Thinking about this exchange now, I chuckle. A cold corn salad? That’s my Bea. Not french fries, not an ice cream sandwich—a cold corn salad. She’s so endearingly random. But at the time I was secretly rolling my eyes: No, you may not have a cold corn salad. You’re getting pizza, and you’re trying to negotiate a side dish? An insidious “salad,” with its inevitable oil, lavished on corn, which banks over 130 calories per cup?
The nutrition doctor had fielded the query well. “No,” she explained. “If you eat a slice of pizza for lunch, that has to be all you have.”
But Bea’s question confirmed for me that we were flirting with disaster by letting her get on that cafeteria line in the first place. Queuing up to snag her pizza confronted her with dozens of other choices, all of which had to be declined. Bea had been demonstrating amazing strength and resolve when provided with adequate guidance, but she still had the typical lapses in nutritional judgment that were appropriate to a seven-year-old. She wasn’t ready for the responsibility yet. So I started sending her to school with a pre-made lunch on Fridays, and our experiment with pizza Friday abruptly ended.
Bea was fine with the shift. In the funny way that kids have of changing their minds from one staunchly held point of view to an opposing one, she had decided that school lunch was gross and that she preferred the lunch I made her.
Along with everyone else in the country, New York City’s public schools are aware of the obesity epidemic and are responding to it. Education programs have debuted, gardening and planting projects have sprouted, and the cafeterias are instituting changes to make their offerings more healthful. Whole-wheat buns have replaced white, vegetarian chili has replaced beef, fresh fruits are available, a salad bar stands at the ready. It’s a step in the right direction. And for the $1.50 I’m asked to pay, it’s an unbeatable bargain.
I don’t criticize the changes, because they may well improve the eating habits of some normal-weight children. While I couldn’t imagine that Bea was going to be able to navigate the choices and stay within her limit of 300 calories for lunch (excluding fruits and vegetables), I wanted to at least investigate the options in the hope that one day they could be options for her. Even if the full meal being served totaled 700 calories, maybe I could advise her to have a half portion of the main dish and no sides, or a salad and a side dish but no main dish. I wanted her to have the chance to eat school lunch on occasion if it would help her feel “normal.” I went online to see what the cafeteria was serving.
The New York City Department of Education’s SchoolFood program provides calorie information to parents who are willing to go through the arcane recesses of the department’s website to find it. I found the school lunch page via Google, selected the month and the borough I live in, and that month’s menu downloaded to my computer. Granted, it was in a cryptic .ashx format with no further instructions on how to open it, but luckily I am a little bit computer-savvy, so I took a stab at changing the suffix to .pdf, and indeed, I was able to read the file.
The menu does not list calories, only the foods being served each day. To get the calories, I had to go back to the website, dig further to find the “menu nutrition information” link, and download that document. Once I’d opened it, I toggled back and forth between the two, looking up each item in that day’s lunch menu and calculating the total calories.
It’s worth noting that some of the items found on the lunch menu are missing entirely from the nutrition information index. And it would probably make lots of interested parents’ lives easier if these numbers were printed on the menu itself. Just a suggestion.
My findings were not surprising, but not encouraging, either. A typical offering was Italian meatballs with tomato sauce, whole-grain pasta, toasted garlic rolls, and “Capri vegetables.” If you leave out the available milk and other extras offered by the cafeteria, the nutrition info suggests that this totals about 450 calories. Another day, they offered mozzarella sticks with tomato sauce and a “Normandy vegetable blend vinaigrette,” also coming out to about 450 calories. It turns out that most of the meals offered, from the hamburger deluxe to the chicken tenders, end up in the 350-to-450-calorie range, if you exclude the add-ons that bring the total to the USDA-mandated minimums.
Those are reasonable amounts for a normal-weight child to have for his lunch, given the recommended daily allowance of 1,600 calories for moderately active kids. But they were definitely too much for Bea. However, there was a new, seemingly better option on the horizon that offered hope that Bea could actually get back on the cafeteria line once in a while.
That year, Bea’s and David’s schools participated in a healthy lunch program under which the most nutritionally bereft ingredients provided by the DOE’s SchoolFood program were jettisoned, and the rest were used to make more healthful meals. I knew they would be subject to the same USDA minimums as SchoolFood was, but I expected the individual dishes would be lower-calorie than their original versions. Maybe this new food would enable Bea to selectively construct a meal that stayed within her limitations.
The program’s website boldly displays obesity factoids in a large font size (“We spend $147 billion annually on obesity related illnesses in the United States”; “In NYC, 1 in 5 kindergarteners is obese”) and states that it seeks to “combat childhood obesity and to promote healthy eating.”
The healthier lunches were already being served at Bea’s school when David’s school decided to introduce them. While often not available to attend PTA meetings because of work or family obligations, I made time to sit in at the one where the program was going to be presented. I was eager to get more info, since my thorough search of their website had provided loads of information but absolutely nothing in the way of calorie counts.
Let me be clear: I’ve never been That Mom. I don’t show up at PTA meetings with a personal agenda. I am fortunate that my children attend excellent public schools with involved parent communities and effective administrations. I think the PTA does a great job, and while I suppose I’d speak up if I disagreed strenuously with something it was doing, I have thus far been content to stay out of it and let the PTA, the school administration, and the teachers do their jobs.
On the occasions on which I am able to attend a meeting, I’m usually both amused and annoyed by the parents who get up and rant about some aspect of what the PTA is doing, from how indoor recess is conducted on inclement-weather days to how much of the PTA’s operating budget is being allocated to the chess program. These parents’ issues generally have such a single-minded focus on the particular interests of their child that their digression is mostly a waste of everyone else’s time.
But as I sat down for the meeting, I realized I was That Mom. And I understood her a little better. I felt a certain compassion for the parents in our mix who feel they must advocate for their kids’ issues, even if no one else shares them—especially if no one else shares them. If they don’t, who will? Sure, sometimes the particular flag they’re waving seems marginal or even ridiculous. But it’s true that a big-city school system isn’t always set up to accommodate the needs of some minorities—such as overweight kids—and it falls to those kids’ parents to stick up for them. Like with the Grinch, my sm
all heart grew a few sizes that day in sympathy with overzealous moms at PTA meetings everywhere.
The healthy-lunch program representative stood up before the crowd of parents—none of whom, to my knowledge, actually struggled with an overweight child—and presented a bunch of grim New York City childhood obesity statistics before explaining how much better and more healthful the new program’s food was.
When she was finished, I raised my hand, and she called on me.
I stood up. “What you’re doing is great,” I said. And I meant it. “My child actually has a weight problem, so I’d love for her to be able to eat this food. But I can’t let her unless I know how many calories are in it. Can you provide that information?”
The lady was really nice, and so I felt a little bad, because I’d searched exhaustively for the information myself and was pretty sure that she wouldn’t have the answer to my question. But at the same time, I was getting tired of people who didn’t have overweight children telling me how to fight my child’s obesity. So many pronouncements on how the problem should be addressed come from healthy-weight people with healthy-weight children. They tell us to make time to have dinner every night with our kids, to engage in regular physical activity as a family, to prepare healthful meals instead of relying on processed foods. As though these decisions were the reasons their children were healthy.
I didn’t feel as if healthy food advocates were intentionally hiding anything about the contents of their meals—it just seemed like they felt the food was so unassailably wholesome and organic that it hadn’t occurred to them that anyone would care how many calories were in it.
That’s fine for the non-overweight kids. I accept that my child has special nutritional needs and doesn’t have to be accounted for in every food initiative. But when you start invoking obesity statistics, you’re talking about my child. You’re giving me hope that you have a solution. So I’m going to need some evidence that what you’re offering can actually help my kid.
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